| NPI | 1477225209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: TX U8699) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX U8699) |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2024-08-27 |